Rural Health
Resources by Topic: Hospitals
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Financial Characteristics of Critical Access Hospitals (CAHs) Participating in Accountable Care Organizations (ACO)
Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) participation in Medicare and non-Medicare Accountable Care Organizations (ACOs) in 2019. Compares the organizational and financial characteristics of CAHs across facilities that participate in ACOs and those that do not participate in an ACO. Includes data on profitability, liquidity, outpatient revenue, and Medicare payer mix.
Author(s): Angelina Budko, George Pink, Susie Gurzenda, Ann Howard, Kristin L. Reiter
Date: 11/2022
Sponsoring organization: Flex Monitoring Team
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Factors Associated with Compliance to the Hospital Price Transparency Final Rule: A National Landscape Study
Examines 3,558 short-term acute-care hospitals' compliance with the Hospital Price Transparency Rule, which requires that hospitals publicly post a machine-readable file containing commercial negotiated prices for 300 services. Compares hospital compliance by state and hospital referral region. Describes factors associated with compliance, including health information technology preparedness, profit status, system affiliation, hospital size, and rural location.
Author(s): John Xuefeng Jiang, Daniel Polsky, Jeff Littlejohn, et al.
Citation: Journal of General Internal Medicine, 37(14), 3577–3584
Date: 11/2022
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Examines 3,558 short-term acute-care hospitals' compliance with the Hospital Price Transparency Rule, which requires that hospitals publicly post a machine-readable file containing commercial negotiated prices for 300 services. Compares hospital compliance by state and hospital referral region. Describes factors associated with compliance, including health information technology preparedness, profit status, system affiliation, hospital size, and rural location.
Author(s): John Xuefeng Jiang, Daniel Polsky, Jeff Littlejohn, et al.
Citation: Journal of General Internal Medicine, 37(14), 3577–3584
Date: 11/2022
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Rural Medicare Beneficiaries are Increasingly Likely to Be Admitted to Urban Hospitals
Examines whether the proportion of rural Medicare fee-for-service beneficiaries admitted to urban hospitals increased between 2010 and 2018 using data from the Hospital Service Area File (HSAF) and the American Hospital Association (AHA) survey. Explores whether distance to the nearest hospital and system affiliation of the nearest rural hospital were associated with increases in urban hospital admissions from rural ZIP codes.
Author(s): Hannah R. Friedman, George Mark Holmes
Citation: Health Services Research, 57(5), 1029-1034
Date: 10/2022
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Examines whether the proportion of rural Medicare fee-for-service beneficiaries admitted to urban hospitals increased between 2010 and 2018 using data from the Hospital Service Area File (HSAF) and the American Hospital Association (AHA) survey. Explores whether distance to the nearest hospital and system affiliation of the nearest rural hospital were associated with increases in urban hospital admissions from rural ZIP codes.
Author(s): Hannah R. Friedman, George Mark Holmes
Citation: Health Services Research, 57(5), 1029-1034
Date: 10/2022
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October 2022 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) October 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, improving access to Medicaid coverage and care for adults leaving incarceration, the unwinding of the Public Health Emergency, streamlining the delivery of home- and community-based services, potential recommendations for structuring Disproportionate Share Hospital allotments during economic crises, and more. Includes rural references and considerations throughout.
Date: 10/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) October 2022 meeting. Covers Medicaid race and ethnicity data collection and reporting, improving access to Medicaid coverage and care for adults leaving incarceration, the unwinding of the Public Health Emergency, streamlining the delivery of home- and community-based services, potential recommendations for structuring Disproportionate Share Hospital allotments during economic crises, and more. Includes rural references and considerations throughout.
Date: 10/2022
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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The Impact of Medicare Shared Savings Program Participation on Hospital Financial Performance: An Event-Study Analysis
Examines the effects of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. Compares within-hospital changes over time between MSSP and non-MSSP hospitals. Includes a comparison of the effects of MSSP participation between Critical Access Hospitals (CAHs) and non-CAHs.
Author(s): Huang Huang, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Citation: Health Services Research, 2022
Date: 10/2022
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Examines the effects of hospitals' participation in the Medicare Shared Savings Program (MSSP) on their financial performance. Compares within-hospital changes over time between MSSP and non-MSSP hospitals. Includes a comparison of the effects of MSSP participation between Critical Access Hospitals (CAHs) and non-CAHs.
Author(s): Huang Huang, Fred Ullrich, A. Clinton MacKinney, Keith Mueller
Citation: Health Services Research, 2022
Date: 10/2022
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Delivery of Cancer Screening and Treatment in Critical Access Hospitals
Summarizes results of a survey of 135 Critical Access Hospitals (CAHs) regarding cancer screening and treatment provided by CAHs. Describes the role of visiting providers and the use of telemedicine in cancer screening and treatment.
Author(s): Megan Lahr, Xiomara Santana, Helen Parsons, Nathan Bean, Ira Moscovice
Date: 10/2022
Sponsoring organization: Flex Monitoring Team
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Summarizes results of a survey of 135 Critical Access Hospitals (CAHs) regarding cancer screening and treatment provided by CAHs. Describes the role of visiting providers and the use of telemedicine in cancer screening and treatment.
Author(s): Megan Lahr, Xiomara Santana, Helen Parsons, Nathan Bean, Ira Moscovice
Date: 10/2022
Sponsoring organization: Flex Monitoring Team
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Assessment of Strategies Used in US Hospitals to Address Social Needs During the COVID-19 Pandemic
Presents findings on efforts to address social determinants of health (SDOH) by rural hospitals, Critical Access Hospitals (CAHs), and safety-net hospitals according to 2020 American Hospital Association survey data. Discusses rates of social needs among patient populations served by rural and urban hospitals and rates of SDOH screening and community partnerships.
Author(s): Jose F. Figueroa, Ciara Duggan, Cristina Toledo-Cornell, et al.
Citation: JAMA Health Forum, 3(10), e223764
Date: 10/2022
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Presents findings on efforts to address social determinants of health (SDOH) by rural hospitals, Critical Access Hospitals (CAHs), and safety-net hospitals according to 2020 American Hospital Association survey data. Discusses rates of social needs among patient populations served by rural and urban hospitals and rates of SDOH screening and community partnerships.
Author(s): Jose F. Figueroa, Ciara Duggan, Cristina Toledo-Cornell, et al.
Citation: JAMA Health Forum, 3(10), e223764
Date: 10/2022
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Factors Predicting Swing Bed Versus Skilled Nursing Facility Use
Examines differences between patients discharged to swing beds versus skilled nursing facilities (SNFs). Features statistics on discharge disposition of people from rural Critical Access Hospital (CAH) and Prospective Payment System (PPS) hospitals, characteristics of people discharged to swing beds or SNFs, with breakdowns by rural CAH discharges and rural PPS discharges, and hospitalization type for discharges to swing beds or SNFs. Includes the 10 most common diagnostic categories for discharges to swing beds or SNFs.
Author(s): Tyler Malone, Mark Holmes
Date: 10/2022
Sponsoring organization: North Carolina Rural Health Research Program
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Examines differences between patients discharged to swing beds versus skilled nursing facilities (SNFs). Features statistics on discharge disposition of people from rural Critical Access Hospital (CAH) and Prospective Payment System (PPS) hospitals, characteristics of people discharged to swing beds or SNFs, with breakdowns by rural CAH discharges and rural PPS discharges, and hospitalization type for discharges to swing beds or SNFs. Includes the 10 most common diagnostic categories for discharges to swing beds or SNFs.
Author(s): Tyler Malone, Mark Holmes
Date: 10/2022
Sponsoring organization: North Carolina Rural Health Research Program
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